Journal of Spinal Disorders & Techniques
Issue: Volume 24(6), August 2011, p 381–385

Sagittal Alignment Comparison of Bryan Disc Arthroplasty With ProDisc-C Arthroplasty: A Prospective, Randomized Controlled Clinical Trial

Yanbin, Zhao MD; Yu, Sun MD; Zhongqiang, Chen MD; Zhongjun, Liu MD
Author Information: Department of Orthopedic Surgery, Peking University Third Hospital, Beijing, China
© 2011 Lippincott Williams & Wilkins, Inc.

Study Design: A prospective, randomized study of the radiographic outcomes in patients undergoing single-level cervical arthroplasty with Bryan disc and ProDisc-C prosthesis.

Objective: The purpose of this trial was to compare the alignment changes of Bryan disc arthroplasty (modified techniques) with ProDisc-C arthroplasty.

Summary of Background Data: Aggravation of kyphosis is the known challenge after Bryan disc arthroplasty. Both Bryan disc arthroplasty with modified techniques and ProDisc-C arthroplasty were reported to avoid the postoperative local kyphosis. There have been no studies comparing the alignment changes after Bryan disc arthroplasty with ProDisc-C arthroplasty.

Methods: We conducted a randomized controlled clinical trial enrolling patients with cervical disc disease. Ultimately 20 patients received Bryan disc arthroplasty with modified surgical techniques and 26 patients received ProDisc-C arthroplasty. Functional spinal unit (FSU) and overall cervical alignment (Cobb angle of C2/7) were compared at final follow-up.

Results: (1) FSU angle: the FSU angle was maintained for the Bryan disc group (from 0.8 to 0.6 degrees) without statistical significance; the FSU angle increased 2.9 degrees for the ProDisc-C group (from -0.3 to 2.6 degrees) with statistical significance. (2) Overall alignment: the overall alignments did not change for both Bryan disc and ProDisc-C groups.

Conclusions: Bryan disc arthroplasty with modified techniques can maintain the lordosis of FSU, whereas ProDisc-C arthroplasty can restore the lordosis of FSU. For the patients with preoperative FSU kyphosis, ProDisc-C arthroplasty may be a better choice to restore the lordosis.